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Associations between general and abdominal adiposity and mortality in individuals with diabetes mellitus

Item Type:Article
Title:Associations between general and abdominal adiposity and mortality in individuals with diabetes mellitus
Creators Name:Sluik, D. and Boeing, H. and Montonen, J. and Pischon, T. and Kaaks, R. and Teucher, B. and Tjoenneland, A. and Halkjaer, J. and Berentzen, T.L. and Overvad, K. and Arriola, L. and Ardanaz, E. and Bendinelli, B. and Grioni, S. and Tumino, R. and Sacerdote, C. and Mattiello, A. and Spijkerman, A.M. and van der A, D.L. and Beulens, J.W. and van der Schouw, Y.T. and Nilsson, P.M. and Hedblad, B. and Rolandsson, O. and Franks, P.W. and Noethlings, U.
Abstract:Individuals with diabetes mellitus are advised to achieve a healthy weight to prevent complications. However, fat mass distribution has hardly been investigated as a risk factor for diabetes complications. The authors studied associations between body mass index, waist circumference, waist/hip ratio, and waist/height ratio and mortality among individuals with diabetes mellitus. Within the European Prospective Investigation into Cancer and Nutrition, a subcohort was defined as 5,435 individuals with a confirmed self-report of diabetes mellitus at baseline in 1992-2000. Participants were aged 57.3 (standard deviation, 6.3) years, 54% were men, the median diabetes duration was 4.6 (interquartile range, 2.0-9.8) years, and 22% of the participants used insulin. Body mass index, as indicator of general obesity, was not associated with higher mortality, whereas all measurements of abdominal obesity showed a positive association. Associations generally were slightly weaker in women. The strongest association was observed for waist/height ratio: In the fifth quintile, the hazard rate ratio was 1.88 (95% confidence interval: 1.33, 2.65) for men and 2.46 (95% confidence interval: 1.46, 4.14) for women. Measurements of abdominal, but not general, adiposity were associated with higher mortality in diabetic individuals. The waist/height ratio showed the strongest association. Respective indicators might be investigated in risk prediction models.
Keywords:Adiposity, Body Mass Index, Diabetes Complications, Diabetes Mellitus, Mortality, Waist Circumference, Waist-Hip Ratio, Abdominal Fat, Abdominal Obesity, Adult, Body Height, Cohort Studies, Confidence Intervals, Europe, Life Style, Multivariate Analysis, Odds Ratio, Prevalence, Proportional Hazards Models, Questionnaires, Risk Factors, Type 2 Diabetes Mellitus
Source:American Journal of Epidemiology
Publisher:Oxford University Press
Page Range:22-34
Date:1 July 2011
Official Publication:https://doi.org/10.1093/aje/kwr048
PubMed:View item in PubMed

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